Republicans press campaign against reconciliation; Mccain seek to strip Medicare out of health bill

USA Today: "Republicans and Democrat hit the Sunday talk shows today to debate whether a complex congressional process called 'reconciliation' should be used to consider a major overhaul of the U.S. health care system. Reconciliation is normally used for 'taxing and spending and reducing deficits,' said Sen. Lamar Alexander, R-Tenn., speaking on ABC's This Week. 'There's never been anything of this size and magnitude and complexity run through the Senate in this way.' White House health care adviser Nancy-Ann DeParle didn't exactly shoot down the idea of reconciliation. On NBC's Meet The Press, DeParle noted that both the House and the Senate have passed separate health care bills, and now lawmakers are seeking to meld them together. 'We're not talking about changing any rules here,' DeParle said. 'All the president's talking about is, do we need to address this problem and does it make sense to have a simple, up-or-down vote?' In the days ahead, President Obama -- who has already proposed a $950 billion health care plan -- is scheduled to outline his own plan for going forward" (Jackson, 2/29).

Politico: "On the verge of a procedural fight over health care, Arizona Sen. John McCain, the Republican's presidential nominee in 2008, said Sunday that he plans to introduce legislation that would prevent Congress from changing Medicare through a process that only requires a simple majority in the Senate. 'Social Security cannot be considered in reconciliation,' McCain said on NBC's 'Meet the Press,' referring to a rule established in the 1970s by veteran Sen. Robert Byrd (D-W.Va.). 'We should do the same thing with Medicare. (Sen.) Lindsey Graham (R-S.C.) and I will be introducing legislation: Entitlements should not be part of a reconciliation process -- i.e., 51 votes. It's too important. … Let's start over. … It's not too late.' Democrats are trying to cut hundreds of billions of dollars from Medicare to pay for their health care bill, something that wouldn't be possible under McCain's proposal" (O'Connor, 2/28).

Roll Call reports: "Senate Budget Chairman Kent Conrad (D-N.D.) on Sunday defended the use of filibuster-busting budget reconciliation rules to pass a narrow bill amending the health care reform legislation passed earlier by the Senate. Conrad said on CBS' 'Face the Nation' that it would be unreasonable and impossible to use reconciliation for the broad overhaul of health insurance reforms, but those have already passed the Senate. The reconciliation package 'would be very limited,' Conrad said, dealing with items such as affordability credits and Medicaid expansion. Conrad said that is consistent with past reconciliation bills, including ones creating the State Children's Health Insurance Program and COBRA insurance" (Dennis, 2/28). 

In another story, Roll Call McCain also said "that backroom deals have marred the debate over health care reform and poisoned the public's attitude toward the legislation. 'Overwhelmingly the American people are saying stop and start over,' McCain said. … McCain specifically said the insurance industry and drugmakers had benefited from 'cynical deals' designed to draw their support for the legislation. 'These were unsavory deals ... done behind closed doors,' according to McCain. … Nancy-Ann DeParle, the president's senior health care adviser, pointed to critical advertising campaigns by insurers as a sign that they had not been bought off with any deals. 'I'm not sure what he's talking about with deals with insurance companies,' she said on 'Meet the Press' (2/28). 

The Hill: "House Majority Leader Steny Hoyer (D-Md.) said Sunday that the House must pass the Senate bill before fixes to both bills can be approved. Hoyer is the highest-ranking House Democrat to outline that path forward, which is perceived as a critical concession to Senate Democrats. 'Whether we're willing or not, we have to go first if we are going to correct thing that the House disagrees with,' Hoyer said on CBS' 'Face the Nation.' The Maryland Democrat's comments provide one of the clearest illustrations yet of how Democrats will proceed to pass their healthcare reform overhaul. Negotiations between the House and Senate Democrats have stalled since Sen. Scott Brown (R-Mass.) broke the Democrats' filibuster-proof majority in the Senate" (Fabian, 2/28). 

The New York Times: "The future of President Obama's health care overhaul now rests largely with two blocs of swing Democrats in the House of Representatives — abortion opponents and fiscal conservatives — whose indecision signals the difficulties Speaker Nancy Pelosi faces in securing the votes necessary to pass the bill." Pelosi is in "the tough spot of trying to keep wavering members of her caucus on board, while persuading some who voted no to switch their votes to yes — all at a time when Democrats are worried about their prospects for re-election. Representative Dennis Cardoza, Democrat of California, typifies the speaker's challenge. The husband of a family practice doctor, he is intimately familiar with the failings of the American health care system. His wife 'comes home every night,' he said, 'angry and frustrated at insurance companies denying people coverage they have paid for.' But as a member of the centrist Blue Dog Coalition, Mr. Cardoza is not convinced that Mr. Obama's bill offers the right prescription. It lacks anti-abortion language he favors, and he does not think it goes far enough in cutting costs. So while he voted for the House version — 'with serious reservations,' he said — he is now on the fence. 'I think we can do better,' Mr. Cardoza said of the president's proposal'" (Stolberg and Pear, 2/27). 

USA Today:  "With each passing day it gets more difficult for the Democrats to pass health care. Literally. Today, Rep. Neil Abercrombie's retirement takes effect as the veteran Democrat devotes his full time to running for governor of Hawaii. Abercrombie voted for the House bill, so that's one more 'yes' vote that House Speaker Nancy Pelosi won't have if she hopes to pass health care using reconciliation. Pelosi has lost three 'yes' votes since Nov. 7. The others: Rep. John Murtha, D-Pa., who died Feb. 8, and Rep. Robert Wexler, D-Fla., who resigned Jan. 3 to become the head of the nonprofit Center for Middle East Peace and Economic Cooperation. The House vote last time was 220-215, so Pelosi will need to convince some of the 39 Democrats who voted against the House bill to vote for the Senate bill -- which is the first step of a two-step reconciliation process. That won't be easy" (Kiely, 2/28).

Fox News:  "Rep. Paul Ryan, R-Wis., said the funding elements of the [health care] bill won't balance spending the way Democrats assert. The Congressional Budget Office's claims for a $132 billion reduction in the deficit over 10 years is based on its inability to strip out aggravating details, he said, but much of the legislation that would be passed through reconciliation involves the double-counting that sends the package into the red. 'The legislation that's been put in front of them is full of smoke, mirrors and gimmicks. ... If you take all the double counting out of the bill, which the CBO can't do because that's the way it's put in front of them, this thing has a $460 billion deficit in the first 10 years, a $1.4 trillion deficit in the second 10 years,' he said" (2/29).

Reuters: Still, the bill's supporters said Democrats will be able to come up with the votes in the House to pass it. "'When we start counting, the votes will be there," Representative Debbie Wasserman-Schultz told NBC's 'Meet the Press.'" DeParle also "she believes 'we will have the votes to pass' the measure" if the Democrats decide to use reconciliation (2/29). 

The Washington Post : "Washington interest groups have burst back into action in hopes of bolstering or defeating a new Democratic push on health-care reform legislation, sparking another wave of rallies, lobbying efforts and costly advertising campaigns. The fresh round offers a clear signal that the industries and advocacy groups most likely to be affected view the coming weeks as the final battle in determining whether Democratic proposals become law. … Reacting to President Obama's recent statements that he will move ahead with legislation, health insurance companies have enlisted hundreds of lobbyists in a full-court press against the proposed overhaul, which would force dramatic cuts and increased regulation on the industry. At the same time, insurers are pushing back against a separate bill approved by the House last week that would remove the industry's antitrust exemption. Pharmaceutical lobbyists are also targeting Obama's plan. ... The National Right To Life Committee -- which strongly opposes the Senate version of the health-care package -- has launched its own grass-roots campaign to pressure dozens of antiabortion Democrats in the House, who are crucial to passage of a final bill. … Democratic and liberal activist groups, meanwhile, are rallying with their own efforts in hopes of pushing legislation across the finish line., for example, said that a "virtual march" organized Tuesday bombarded lawmakers with more than 1 million pro-reform e-mails. … One glaring exception to the renewed activity is AARP, the 40 million-member seniors group, which has spent millions on advertising and other efforts over the past year in favor of Obama's health-care plans. A. Barry Rand, the group's chief executive, called on other groups last week to lower the temperature in the debate so that 'compromise is possible.'" (Eggen, 2/28).

In another article, The Washington Post: "Thursday's largely civil and intelligent summit underscored the deep philosophical gulf that remains between the two sides over health care (and many other issues). Both agree that the health-care system needs repair but significantly disagree over how to fix it. That is a genuine difference that seven hours of talking did not begin to narrow" (Balz, 2/28).

On the topic of health care, President Obama had a physical Sunday. The Associated Press reports the White House physician said the president "is in 'excellent health' and 'fit for duty.' …  Navy Capt. Jeffrey Kuhlman said after the 90-minute exam at the National Naval Medical Center in Bethesda, Md., that he saw nothing that would prevent Obama from fulfilling his term as president. According to a White House release after the exam, Kuhlman recommended that Obama 'continue smoking cessation efforts' and modify his exercise regimen to strengthen his leg muscles to overcome occasional pain from chronic tendinitis in his left leg. The report said Obama uses a nonsteroidal anti-inflammatory for the tendinitis and 'nicotine replacement therapy' -- believed to be nicotine gum -- in his bid to quit smoking. Obama said at a June news conference that he still had an occasional cigarette. It was his first public acknowledgment that he hadn't kicked the habit" (Hurst, 2/28)

http://www.kaiserhealthnews.orgThis article is republished with kind permission from our friends at The Kaiser Family Foundation. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery of in-depth coverage of health policy developments, debates and discussions. The Daily Health Policy Report is published for, a free service of The Henry J. Kaiser Family Foundation. Copyright 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.


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